Spatio-temporal patterns of malaria in Nepal from 2005 to 2018: a country progressing towards malaria elimination

Elsevier

Available online 1 February 2023, 100576

Spatial and Spatio-temporal EpidemiologyAuthor links open overlay panel, , , Highlights•

Nepal is preparing for elimination by 2026.

Spatial variation in temporal trend method used to detect and generate unusually high or low temporal trend of malaria indicators.

Indigenous malaria increasing by 113.71% and imported malaria increasing by 156.22% in two different clusters.

All indicators have clusters of increasing malaria trend.

The decreasing clusters also have rate of decrease lower than outside the clusters.

Abstract

Nepal aims to eliminate malaria by 2026. This study analyzed district-level spatio-temporal patterns of malaria in Nepal from 2005 to 2018, following the introduction of Long-Lasting Insecticidal Nets (LLINs) for vector control intervention. The spatial variation in a temporal trend (SVTT) method in SaTScan was used to detect significantly high or low temporal trends of five malaria indicators: Indigenous, Imported, PV (Plasmodium vivax), PF (Plasmodium falciparum), and Total Malaria; results were mapped as clusters with associated trends. Spatial clusters of increasing malaria were found for all five indicators. Indigenous Malaria increased 113.71% in a cluster of three previously non-endemic mountainous districts. The most prominent cluster of Imported Malaria increased by 156.22%, and included the capital, Kathmandu. While some clusters had decreasing malaria, the rate of decrease in clusters was lower than outside the clusters. Overall, malaria burden is decreasing in Nepal as the country progresses closer to the elimination deadline. However, spatial clusters of increasing malaria, and clusters of lower rates of decreasing malaria, point to a need to focus vector control interventions on these clusters.

Keywords

Malaria elimination

Nepal

Spatial Variation

Temporal Trend

Spatio-temporal pattern

Control intervention

AbbreviationsLLINs

Long-Lasting Insecticidal Nets

WHO

World Health Organization

GMEP

Global Malaria Eradication Project

DDT

Dichloro-diphenyl trichloroethane

IRS

Indoor Residual Spraying

VDCs

Village Development Committees

GIS

Geographic Information System

DoHS

Department of Health Services

EDCD

Epidemiology and Disease Control Division

CBS

Central Bureau of Statistics

ICIMOD

International Center for Integrated Mountain Development

SVTT

Spatial Variation in Temporal Trend

GFTAM

Global Fund for Tuberculosis, AIDS, and Malaria

ACT

Artemisinin-based Combination Therapy

Data Availability

All data are described in the paper and websites made available.

© 2023 The Author(s). Published by Elsevier Ltd.

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